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Tri 6 - Tumors > Benign Tumors > Flashcards

Benign Tumors Flashcards

1
Q

T/F: Bone islands typically do not appear “hot” on bone scans

A

TRUE

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2
Q

are composed of
cortical bone, and appear as low
signal intensity on MRI on all
pulse sequences

A

bone islands

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3
Q

typically appear as round-to-ovoid sclerotic intramedullary foci

A

bone island

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4
Q

Cortical bone that has failed to undergo medullary
resorption during the process of endochondral
ossification

A

Bone Island: (Enostoma)

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5
Q

– Located anywhere, except in skull – Discrete area of sclerosis in bone – Asymptomatic and clinically insignificant

A

Bone Island (BI): (Enostoma)

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6
Q

distinguishes BI from blastic metastasis

A

Brush border

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7
Q

– Age 10-25 yo – Pain relieved by Aspirin – Gradual severe deep aching pain – Pain could be referred to a nearby joint – Pain worse at night – Limited ROM, painful limp, stiffness, weakness

A

Osteoid Osteoma

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8
Q

– Painful rigid scoliosis: usu on concave side

of curve – 50% in tibia and femur – 10% in spine affecting posterior elements

A

Osteoid Osteoma

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9
Q

– Usu <1.0 cm in size – Radiolucent nidus with surrounding reactive
sclerosis – Nidus may calcify

A

osteoid osteoma

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10
Q

Highly vascularized fibrous connective tissue

A

nidus (tumor)

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11
Q

T/F: May need CT & Bone Scan for spinal lesions

A

TRUE

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12
Q 
– DDX:
• Spondylolysis
• Congenital agenesis of contralateral pedicle
• Osteoblastoma
• Blastic metastasis
• Brodie’s abscess
• Stress Fracture
• Garre’s Chronic Sclerosing Osteomyelitis
A

osteoid osteoma

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13
Q

– DDX:

• Blastic metastasis • Osteoid osteoma • Osteoma • Osteopoikilosis

A

Bone Island: (Enostoma)

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14
Q

• Pain is relieved by aspirin and nonsteroidal anti-
inflammatory drugs • Very high levels of prostaglandins have been found in the
lesion

A

Osteoid Osteoma

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15
Q

– Aspirin also relieves pain – Pain worse at night – Nidus >1.0 cm in size – No angiographic vascular blush

A

Brodie’s Abscess

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16
Q

Osteoid Osteoma tx:

A

NSAIDS until pain subsides

Thermocoagulation (92% case success)

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17
Q

An insulated SMK C-15 electrode was inserted through
the cannula into the lesion and its position confirmed by
CT imaging

A

THERMOCOAGULATION

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18
Q

– Peak age range 10-20 yo – Usually located in posterior neural arch of spine – Pain, that is usually not at night, and not relieved by aspirin

A

Osteoblastoma

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19
Q

– Painful scoliosis – 2-10 cm in size – Expansile lesion with eggshell-thin cortical margin – May be sclerotic

A

Osteoblastoma

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20
Q

T/F: Small percentage of osteoblastomas become malignant

A

TRUE

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21
Q

shows fluid in MRI: T1 or T2

A

T2

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22
Q

– Arises from residual islands of cartilage left in metaphysis
as physis grows away – Hands (50%) and feet

A

Solitary Enchondroma

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23
Q

mc location solitary enchondroma

A

hand

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24
Q

solitary enchondroma: Sudden onset of pain without trauma signals _______

A

malignant transformation

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25
Q

50% have punctate calcification due to

cartilagenous matrix

A

Solitary Enchondroma

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26
Q

Post trauma introduction of epidermoid tissue into bone

A

Inclusion cyst

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27
Q

Neuroarterial lesion in hand causing pressure erosion of tuft

A

Glomus tumor

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28
Q

if surgery… Replace with bone chips, or cement packing (calcium
phosphate packing)

A

Solitary Enchondroma

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29
Q

Enchondroma with malignant transformation to a

A

Chondrosarcoma

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30
Q

T/F: Solitary Enchondroma is more likely malignant if hot on bone scan

A

TRUE

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31
Q

– Unossified remnants of cartilage in diaphyses and metaphyses – Not usu painful, unless pathologic fracture – Likes small bones of hands and feet – Large lesions result in bone deformities

A

Multiple Enchondromatosis

32
Q

aka Ollier’s disease

A

Multiple Enchondromatosis

33
Q

_____ is helpful to detect malignant degeneration of Multiple Enchondromatosis

A

MRI

34
Q

Multiple radiolucent metaphyseal lesions of the proximal and middle phalanges of the fourth and fifth digits, and the distal metacarpals of the fourth and fifth digits

A

Multiple Enchondromatosis

35
Q

– Enchondromatosis of bone and soft
tissue cavernous hemangiomas
– Rare
– MC affects hands

A

Maffucci’s Syndrome

36
Q

These hemangiomas in Maffucci’s syndrome are benign
and asymptomatic, however may
turn _____

A

malignant

37
Q

maffucci’s:
Areas of radiolucency
represent enchondromas, and
opaque spots represent

A

phleboliths

38
Q

T/F: The hemangiomas may occur in
other organs, including the GI
tract

A

TRUE

39
Q

The incidence of malignant
transformation is higher in
____ compared to Ollier’s

A

maffucci’s

40
Q

– Rare primary benign bone tumor of cartilage origin
– 10-25 yo
– Arises from cells of physis – Pain, and pain in nearby joint
– Local tenderness and swelling

A

Chondroblastoma:

Codman’s tumor

41
Q

Chondroblastoma located where in the bone

A

Epiphyseal and Apophyseal (tuberosity or trochanter)

42
Q

what is bright in a T1 sequence MRI

A

bone marrow

43
Q

– Classified as a tumor of cartilagenous origin
– Rare
– Composed of chondroid, fibrous, and myxoid
tissues in varying proportions

A

Chondromyxoid Fibroma

44
Q 
– 1-10cm in diameter 
– Local pain with swelling
 – May be incidental finding
– Usu Proximal Third of Tibia 
– Metaphyseal origin
A

Chondromyxoid Fibroma

45
Q 
– 4-8 yo
 – Asymptomatic 
– Posterior – medial surface of DISTAL FEMUR, lower extremity
 – Could be associated with avulsion
fracture at a muscle attachment
A

Fibrous Cortical Defect

46
Q 
– 8-20 yo 
– Due to faulty ossification, and not a true neoplasm
 – Usu asymptomatic 
– Large lesion may be painful,  >8 cm
• Pathologic fracture
• Stress fracture 
– MC distal tibia
A

Non-Ossifying Fibroma

47
Q

– Lytic, eccentric, ovoid, thins and expands cortex
– Multilocular appearance
– 2-7 cm in length
– Dense sclerotic border along medullary side
– Periosteal reaction with pathologic fx
– No malignant transformation

A

Non-Ossifying Fibroma

48
Q 
• Lobulated well-circumscribed
nonossifying fibroma that is
eccentrically located within the
distal tibial metadiaphysis 
• Peripheral sclerotic border with
a central lucency is typical of
this lesion
A

Non-Ossifying Fibroma

49
Q

– Aka unicameral (one house) _____
– Fluid filled cyst lined with thin layer of fibrous tissue
– 3-14 yo
– 2/3 undergo pathologic fx

A

simple bone cyst

50
Q

– Originates in metaphysis (_____ cyst)

A

active

51
Q

– Latent cyst in diaphysis (_____ cyst with growth potential)

A

latent

52
Q

– Geographic or cystic radiolucency that is broad at
metaphyseal end, and narrower at diaphyseal end
– Truncated cone shaped appearance
– Endosteal scalloping
– Light, incomplete septation
– No Matrix Calcification

A

simple bone cyst

53
Q

simple bone cysts are exposed in what type of image

A

MRI T2 w/ fat suppression or stir/spur

54
Q 
simple bone cyst: 
• Small, detached, floating bone
fragment 
• Changes position in cyst with
movement
A

fallen fragment sign

55
Q

simple bone cyst:
If fragment is attached at one end, but opposite end moves with
movement

A

Hinged Fragment Sign

56
Q

Oval, geographic radiolucent lesion in subtalar region of anterior calcaneus

A

Calcaneal Cyst

57
Q 
– Cystic cavity filled with blood 
– Channels containing flowing blood 
– Not a true cyst
– Not an aneurysm
– Pathogenesis is not known  (probably posttraumatic)
A

Aneurysmal Bone Cyst

ABC

58
Q

– Likes posterior neural arch of spine, therefore see
neurological changes relating to spinal stenosis
– 5-20 yo
– Acute pain with RAPID increasing severity of pain
– Frequent pathologic fx

A

Aneurysmal Bone Cyst

ABC

59
Q 
– Expanding fast growing
 – Thinning of cortex  (EGGSHELL) 
– Soap bubble 
– May cross growth plate and affect epiphysis 
– 8-10 cm in size
A

Aneurysmal Bone Cyst

ABC

60
Q

tx of Aneurysmal Bone Cyst

A

– Surgical curettage packed with bone chips

– High recurrence rate

61
Q

Rarest primary benign bone tumor
Age 5-70 yo
Usually asymptomatic Usually found incidentally mc in metaphyses of long bones, particularly tibia and fibula, calcaneus and metatarsals

A

Intraosseous Lipoma

62
Q
  • Lytic lesion with well defined or sclerotic border
  • May be expansile with endosteal scalloping
  • Calcific radiopacity of central necrosis
A

Intraosseous Lipoma

63
Q 
– Slow growing 
– Composed of newly formed capillary, cavernous,
or venous blood vessels 
– Usually asymptomatic 
– MC benign bone tumor of spine
A

Hemangioma

64
Q

Most symptomatic spinal hemangioma lesions are in the _______
spine since spinal canal vs. cord size is smallest

A

mid thoracics

65
Q

T/F: Hemangioma in Maxilla and Mandible may result in death during tooth extraction due to exsanguination of blood

A

TRUE

66
Q

– 75% of lesions are located in spine and skull
– Lower thoracic and upper lumbar region
– May extend into posterior neural arch 10-15%
– If in skull, usually frontal bone

A

Hemangioma

67
Q

_______ hemangiomas are most common

A

Cavernous

68
Q

Spherical calcifications represent ______
which characterize the vascular nature of the soft
tissue mass lesion

A

phleboliths

Soft Tissue Hemangioma

69
Q

CT: Polka Dot Appearance
MRI: Jailhouse Appearance, Corduroy Cloth Appearance

A

Hemangioma

70
Q

The most commonly affected bones in the skull are the ______, and life-threatening bleeding after a simple tooth extraction is frequently observed

A

mandible and the maxilla

71
Q

– Bony exostosis projecting from external surface of bone
– Usually has hyaline lined cartilagenous cap
– MC benign skeletal growth or tumor

A

Solitary Osteochondroma

72
Q 
– Metaphyseal 
– Calcified cartilagenous cap 
– Points AWAY from joint due to muscle pull 
– Coat hanger exostosis 
– Knee mc affected
A

Solitary Osteochondroma

73
Q

– Multiple osteochondromas – 2-10 yo
– 2-100’s of osteochondromas, average of 10
– Usually bilateral and symmetric
– Painless lumpy joints

A

HME: Hereditary Multiple Exostoses

74
Q
  • Shortening of ulna

* Outward bowing of radius • Subluxation of radioulnar joint

A

Bayonet Hand Deformity

HME

75
Q

T/F: Lesions (HME) within or close to axial skeleton are most likely
to degenerate to malignancy

A

TRUE

Tri 6 - Tumors (5 decks)

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